J Korean Orthop Assoc.  2017 Jun;52(3):285-289. 10.4055/jkoa.2017.52.3.285.

Contralateral Nerve Root Compression after Direct Lateral Lumbar Interbody Fusion

• Son SM
• Kim TH
• Shin JK
• Lee JS

• KMID: 2384560
• DOI: http://doi.org/10.4055/jkoa.2017.52.3.285

Abstract

Direct lateral lumbar interbody fusion (DLIF) has been introduced as an effective new thoracolumbar fusion technique for patients with degenerative lumbar diseases. DLIF associated with easy-to-learn, high fusion rate, improved restoration of spinal alignment, and early patient mobilization due to minimally invasive nature. However, ipsilateral L2-L5 nerve root irritation and injury are well-known complications. However, damage to the contralateral nerve root has been rarely reported and, to the best of our knowledge, there have not been any reports about contralateral nerve root injury after DLIF in Korea. Thus, we report a case of contralateral nerve root compression due to osteophyte from the lower endplate of the vertebral body and position of intervertebral cage after DLIF.

Keyword

direct lateral lumbar interbody fusion; contralateral; nerve root compression

MeSH Terms

Humans
Korea
Osteophyte
Radiculopathy*

Figure

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  Figure 1 A 72-year-old female patient with L4–5 spinal stenosis. (A) Loss of lumbar lordosis and L4–5 severe degenerative change is shown on lateral radiography. (B) Enlarged osteophytes are shown around L4–5 and right L4 foraminal space. (C, D) Severe central and foraminal spinal stenosis at the L4–5 level in T2-weighted magnetic resonance imagings, especially with greater severity on the right side.

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  Figure 2 Postoperative radiographs. Anteroposterior (A) and lateral (B) radiographs show direct lateral lumbar interbody fusion, posterior decompression and fusion using pedicle screws on L4–5 level. On lateral radiograph, enlarged intervertebral and foraminal spaces are shown.

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  Figure 3 Postoperative T1-weighted magnetic resonance imagings. Right L4–5 neural foramen is severe narrowed (A, white arrow) and L4 nerve root is compressed even though after surgery (B). (C) Interbody cage is located diagonally with direction from left anterior entry point to right posterior near right neural foramen.

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